How to stop worrying about cancer returning

Getting the all clear after a cancer diagnosis is what every cancer survivor hopes to hear. But once treatment is over and life returns to normal, fear of it returning can set in. Here's how to manage your anxiety

Despite huge advances in treatment and improving survival rates, cancer remains a diagnosis that strikes fear into our hearts. "The fear factor that surrounds cancer makes it almost impossible to see it as 'just' another serious disease," says Professor Gerry Humphris, professor of health psychology at the University of St Andrews and co-author of a 2013 study into the fear of cancer recurrence in adult cancer survivors.

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"At first, patients are incredibly grateful that treatment has worked but then anxiety about the cancer recurring sets in. Sometimes they experience swelling or odd sensations that are a normal part of the healing process but which patients take to be symptoms. It's very distressing and can result in self-examination or checking that becomes obsessional and repeated trips to their GP or outpatients clinic. Of course, we'd expect all those recovering from cancer to have some concerns, but current evidence suggests around 40% of survivors have moderate levels of fears of recurrence while one in 10 are extremely anxious indeed."

How to manage your fear of cancer recurring

1. Challenge unhelpful thinking

"Fear and anxiety after cancer treatment is absolutely normal, but it's important to manage those feelings so they have less of an impact on your daily life," says Caroline Geraghty, senior cancer information nurse at Cancer Research UK. "While patients are being treated, they are often very busy with appointments. After treatment, they have more time on their hands, which is when they start to worry. Some people are more prone to worrying than others but what's true for everyone is that the fear becomes less with time, which can be a very comforting thought to hold onto."

Try asking yourself the following questions

Are my worries reasonable? What's the evidence for and against the cancer returning?

What advice would I give to a friend who was having similar thoughts?

Am I getting things out of proportion? For example, negative thinking is this: 'The cancer will come back and I can't cope with more treatment.' Balanced thinking is this: 'My doctor said there's a good chance the cancer won't return, but if it does, I've coped with treatment before so can probably do it again.'

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2. Go to your follow-up appointments

Going back to hospital may trigger anxiety but it's important that you go, so that your doctor or nurse can check that everything is as it should be. Most people feel reassured afterwards. It's your chance to talk to your doctor or nurse about your worries - write them down before you go. "You'll be supported in your recovery by a specialist nurse who understands the type of cancer and treatment you had so that you get advice specific to you," says Caroline. "They can talk to you about what to expect as you recover and will also be the link with your GP."

3. Join a support group

"Women, in particular, find support groups helpful," says Caroline Geraghty. Whether it's an online forum or group of people you meet with every week, it can be helpful to talk to other people who've had similar experiences to you. Some support groups offer relaxation techniques, massage or aromatherapy.

4. Look after yourself

Just knowing that you're looking after your physical and mental health can make a big difference to your levels of anxiety. Regular exercise, a healthy diet and making time to relax will not only support your body as it recovers but keep your hormones balanced, helping you feel calmer. Try to stay away from the kinds of foods that will send your blood sugar levels soaring, and remember that too much booze is actually a depressant and can make you feel very anxious. Never underestimate the power of a good walk.

Six on-on-one sessions with a specialist cancer nurse significantly reduced fears of recurrence

5. Seek counselling

It might be helpful to see a psychologist or counsellor who can help you work through your fears. "Psychological intervention can help," confirms Professor Humphris. "Cancer Research UK found that six on-on-one sessions with a specialist cancer nurse significantly reduced fears of recurrence and that anxiety was reduced for months afterwards." As well as CBT, mindfulness and meditation, another type of therapy that can help is Acceptance and Commitment Therapy (ACT), which focuses on accepting that some things are beyond our control but that we are still able to commit to activities that make us feel happy and fulfilled.

6. Don't be afraid to look ahead

"Some patients are so traumatised by their experience that they find it impossible to do things like booking a holiday in case they're not around to enjoy it," says Professor Gerry Humphris. "The chances are that they will be, of course, and the holiday after that." Having something to look forward to, and a sense of purpose, is a positive distraction from your worries so seek out new people and new experiences. No-one chooses to have cancer but it can change your life in a positive way – if you let it.

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